Riley, at 1 month on Steroids

It's been 4 weeks since our vet visit where we started Riley on Prednisone (5 mg, every 12 hours).  He started eating within 36 hours of the medication and, basically, hasn't stopped since.  His appetite is voracious.  He pees a lot, but he's adjusted to this very well and, such a good boy that he is, there have been no accidents in the house!

Also, we started him on antibiotic therapy for Helicobacter, just in case that has been playing a role.  Dr. Mlekoday wanted him to start when he was more than 3 weeks into the steroids and tolerating them well, so we started them this week, and he's tolerating those well, too.

Anyway, today's visit was with Dr. Chad West at Animal Medical Center.  He is Riley's new Neurologist.  Such a rock star, that guy!  Amazing mind and a kind personality.  Riley really likes him, and so do we.  This is the gist of things, and I'm quoting from his follow up email/consultation note to Riley's family vet (Dr. Mlekoday):

"Riley looks great and has been doing well at home. He seems to be handling the steroids fairly well; although, he has developed muscle wasting in his abdomen and along his spine. 

We discussed the typically recommended steroid tapering course and decided to initiate the taper at this time. I discussed that the taper will be gradual and unless there is recurrence, will follow this course:
Prednisone 2.5 mg po bid X 4 weeks,
Then 2.5 mg po Q24 X 4 weeks, 
Then 2.5 mg Q48 for 4 weeks. Then discontinue. 

I recommended blood work be checked in 6 weeks to include cbc/chem panel/cpli, +/- gi panel. This should serve as a baseline to see how Riley handles the continued taper."

So, as you can see, we're going to be doing steroids through the end of January.  Not bad, so long as Riley stays hungry and asymptomatic. 

I asked Dr. West his frank opinion about all of the pancreatic markers, the concerns about Riley's diet, the possiblity of this being chronic pancreatitis vs. helicobacter, etc... and he said that he really thought those were all incidental to the central issue, being the immune-mediated inflammation in his brain.  He he said that the cpli and gi panel are really sensitive tests and they often pick up on minute changes that, while clinically in the "abnormal" range, really tend to be in the "it's fine, leave it alone" range for that individual.  His hope is that when we repeat bloodwork in 6 weeks, either things will be different and back to normal or else we'll come to realize (if there is little change from the other numbers) that this is just Riley's "normal".  He said that, while it's possible that as we start to taper, Riley will start to lose his appetite again, it's incredibly unlikely and he'd be totally surprised if that happened.

In any case, today was a great day.  And as I type this, Riley is ravenously and enthusiastically chomping down on his plant-based dinner downstairs.  It feels like all is well in the world, again.  

Here's hoping...